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Related Concept Videos

Allergic Drug Reactions01:27

Allergic Drug Reactions

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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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The reaction of weakly electrophilic aryldiazonium (also called arenediazonium) salts with highly activated aromatic compounds leads to the formation of products with an —N=N— link, called an azo linkage. This reaction, presented in Figure 1, is known as diazo coupling and occurs without the loss of the nitrogen atoms of the aryldiazonium salt. Highly activated aromatic compounds such as phenols or arylamines favor the diazo coupling reaction. The coupling generally occurs at the...
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A Rare Skin Rash: Linezolid-Induced Purpuric Drug Eruption without Vasculitis in a Puerto Rican Man.

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Purpuric cutaneous drug reactions are rare but serious adverse effects of linezolid. Promptly identifying and discontinuing linezolid is crucial for patient recovery from these skin manifestations.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Pharmacology

Background:

  • Cutaneous adverse drug reactions (cADRs) manifest as skin responses to systemic drug exposure.
  • Linezolid, an oxazolidinone antibiotic, is vital for treating methicillin-resistant Staphylococcus aureus (MRSA).
  • Purpuric cADRs from linezolid are infrequently documented.

Observation:

  • An 89-year-old Puerto Rican male developed a widespread purpuric rash 5 days after initiating oral linezolid for healthcare-associated pneumonia.
  • The patient's symptoms necessitated immediate drug discontinuation.
  • Abdominal punch biopsy confirmed a superficial, perivascular lymphocytic infiltrate with dermal eosinophils, indicative of a purpuric drug eruption.

Findings:

  • The case highlights a rare presentation of linezolid-induced purpuric drug eruption.
  • Histopathological findings aided in diagnosing the condition and differentiating it from other causes like cutaneous vasculitis.
  • Early diagnosis and intervention are key to managing this adverse reaction.

Implications:

  • Clinicians must maintain awareness of rare linezolid-induced cutaneous reactions.
  • Prompt identification and withdrawal of the offending agent are essential for effective management.
  • Treatment strategies include avoidance of linezolid and supportive care with corticosteroids, antihistamines, and barrier ointments.